The present invention relates to a device and method for analysis involving at least two factors, with at least two of the factors related to each other.
When multi-factor analysis of interrelated factors is attempted, the individual often has difficulty keeping track of which factors may have already been considered and what the relationship of those factors might be for a particular set of circumstances or facts. The same problem exists when two or more persons analyze such related factors, and may even be more complex and confusing depending on the role and contributions of those persons. Exemplary types of multi-factor analysis of related factors include, but are not limited to, those of biopsychosocial analysis and the analysis of the assets or capital of a business entity. Each of these examples is discussed in greater detail herein to assist in understanding the complexities associated with such analysis.
The dominant model of health care for health and illness is the xe2x80x9cbiomedical modelxe2x80x9d, also referred to as the xe2x80x9cmedical modelxe2x80x9d. This model is based on the assumption that illness results from physical causes, such as trauma or infection, for example. Therefore, psychosocial processes are not factors that cause disease under the biomedical model, as a person""s illness or sickness must result from a disordered part of the body or from a pathological disease process. Problems with mood, emotion, thought or behavior are frequently categorized and analyzed as mental disorders or psychological disorders under the biomedical model.
Although there are limitations to the biomedical model, other models have had less widespread acceptance or use. The biopsychosocial model is one of those alternative models. The biopsychosocial model posits that health involves the interaction of biological psychological, and social/environmental factors in a person""s life. In other words, health depends upon: (a) biological factors like structural defects (e.g., heart valve), weak function (e.g., inability to fight infection), or overactive function (e.g., allergy); (b) psychological factors including cognitive activities such as learning, remembering, analyzing, and emotional factors such as joy, anger, fear or sadness; and (c) social factors, including the closest social relationship (e.g., family) as well as reciprocal interactions with other individuals and institutions in the community.
Although the role of biological, psychological and social/environmental factors in health and disease is increasingly acknowledged, there is extreme lack of understanding about how these components interplay in wellness and illness. Such lack of understanding is due, in part, to the complex processes involved in analyzing linkages between personal, biological, psychological, and social/environmental data, and the increasingly limited contact time of a patient with health care professionals, including physicians. These problems may be expressed in other ways:
(a) Widespread physician beliefs and practices reinforce and perpetuate the overwhelmingly prevalent biomedical model. Consider, for example, the fact that very few physician-patient interactions include a balance of biomedical and psychosocial topics. Many such interactions do not result in an understanding of how these factors interplay or are used in effective, focused, joint decision-making. Physicians are more likely to perceive patients with psychosocial problems like depression or anxiety as xe2x80x9cdifficultxe2x80x9d; such patients experience poorer functional status, unmet health expectations, reduced satisfaction, and greater use of health care services. Most patients are willing to confide psychosocial information to their physician, but rarely do unless a physician has previously expressed a specific interest. Thus, life events and social difficulties tend to merge indirectly as a part of a description of physical symptoms. Gynecologists are the de facto primary care physicians for many women, but a gynecologist""s training emphasizes surgery, office procedures, infection, and metabolic disease treatment. Thus, such training provides little exposure to management of psychosocial problems. Referring patients with psychosocial problems to psychiatrists is inconvenient and expensive. For many patients with physical complaints, no organic cause can be found. One study showed that a psychiatrist evaluation and analysis improved subsequent treatment by the primary physician, but this also added greater complexity, cost, and inconvenience to the care process.
(b) The lack of biopsychosocial information leads to unnecessary suffering and expense. The most dramatic examples of this lack of information occur with syndromes such as chronic fatigue, chronic whiplash, repetition stress injury, and fibromyalgia. All these syndromes include a cycle in which a person connects continuing physical symptoms to an underlying serious disease. By thinking the problems will become worse and by expecting disability, a person can easily reinforce and perpetuate symptoms in a vicious cycle; assuming the xe2x80x9csick rolexe2x80x9d can prevent a person from ever getting well. Often stress remains an unresolved ongoing problem that affects an individual""s well being and his or her ability to relate to others in a mutually beneficial manner.
(c) By not identifying and understanding the effect of life stressors, individuals confuse and confound the care process. The tendency in many instances to only address physical symptoms may lead people to cease seeking further medical advice if their needs are not met. Alternatively, an individual may frequently change physicians or see multiple physicians. These activities increase overall medical expenses, especially as people get older. Not understanding the biological, psychological, and social changes of an individual situation can increase distress and exacerbate the discomfort of chronic illness.
(d) Major health problems must have an integrated biopsychosocial approach for effective management and treatment. Such an integrated approach may be more expensive and is inherently more complex. The previously narrow biological paradigm of asthmatic disease is evolving in a way that gives scientific credibility to such an approach. The field of psychoneuroimmunology links psychosocial stress, the central nervous system, and changes in immune and endocrine function. This field describes biological paths by which stress affects respiratory function. Stress affects autonomic control of airways. Stressors such as living near a nuclear plant accident, being an Alzheimer""s Disease caregiver, or taking difficult school exams have all been scientifically shown to affect the number and function of white blood cells. Stress triggers release of hormones that affect immune cells and increase susceptibility to viral respiratory infections. Management of asthma is a paradigmatic example of how the effects of family function, social support, thinking, personality, self-concept, stress, and coping ability are all important factors associated with favorable or unfavorable outcomes.
(e) Opportunities to improve one""s physical condition are missed by not understanding one""s psychological experience. People with even moderately severe asthma or rheumatoid arthritis who write about their stressful life experiences have significant clinical improvement. Depressive symptoms or lack of social support have been shown to affect cholesterol levels. Feelings of anger and hassle influence insulin and glucose metabolism in non-diabetic adults. Such findings occur not only in the United States, but throughout the world. Gastrointestinal diseases have exemplified the impact of psychological factors. Psychological factors impact diseases such as gastroesophageal reflux disease, chronic abdominal pain, Crohn""s Disease, and Irritable Bowel Syndrome.
(f) Health professionals are not in a position to make the biopsychosocial model part of their practice. Such professionals continue to be trained using the biomedical model, and time pressures and constraints of their practices make evolution to a different model difficult. Use of the biomedical model results in a narrow view of the patient in terms of a disease to be diagnosed, treated, and cured, rather than as a person with an illness whose healing requires an understanding of the individual""s personal situation. Treatment also requires collaboration between physician and patient.
(g) Without effective tools, use of a biopsychosocial model can be difficult to implement, excessively time consuming, or more expensive when compared to use of the biomedical model. Educators exhort physicians to be more empathetic, use opportunities for praise, learn moral reasoning, and develop a sense of duty. Physicians are advised to develop interviewing skills and not cut patients off in mid-sentence. Physicians are instructed to explore their feelings and raise their own level of awareness by avoiding burnout and attending support groups. Other resources recommended include educational videos, or written summaries of visits sent to the patient. None of these recommended techniques, skills, or resources have consistently had a measurable effect on health outcomes.
It is desired to develop a novel solution to the above problemsxe2x80x94to provide a tool to allow people to discover personal biopsychosocial linkages prior to a professional encounter. Such a tool should be able to facilitate the physician-patient interactions by: (a) permitting patients and health professionals to recognize factors (such as anxiety, depression, illness beliefs, feelings about care) that perpetuate illness; and (b) allow patients to limit and control factors that precipitate illness by improving stress management skills, social support, and preventive health measures.
Despite the transformation in many industries from manufacturing to knowledge-based companies, most businesses have failed to maximize their total market value due to failure to develop their intellectual capital. Most businesses have recognized the value of traditional forms of capital such as financial capital and physical capital as well as the capital value inherent in the structure and processes of any organization. Many businesses have also recognized the capital value of certain human resources, for example, employee knowledge and skills.
But in today""s business world, there is increasing recognition of an important xe2x80x9chidden valuexe2x80x9d of intellectual capital beyond the types of capital described above. Intellectual capital, among other things, consists of employee motivation and behavior, the organization""s motivation and behavior, employee relationships, customer relationships, and the organization""s relationships. Developing, applying, and leveraging these forms of intellectual capital are competitive areas of today""s economy in which business market value depends increasingly on larger numbers of highly skilled employees.
Most businesses fail to recognize these hidden forms of intellectual capital because their organizational structure still reflects origins in Classical Management Theory that dates from the early part of the twentieth century. Based on mechanistic principles, Classical Management Theory put major emphasis on top-down command from management""s centralized authority. In response, employees were expected to develop discipline and obedience. By de-emphasizing the thoughts, feelings, and interrelationships of workers, Classical Management Theory facilitated the assembly-line workplace common in many manufacturing, retail, and service industries. Over many years, this assembly line structure has naturally led to the replacement of skilled with unskilled workers. But in the current era, Classical Management Theory has become increasingly ineffective in maximizing the value of capital because of the transformation to knowledge-based industries with many skilled workers.
Most recent schools of management theory such as the Human Relations Movement (based on the work of Maslow et al.) and the Total Quality Movement (based on the work of Deming et al.) have reacted against the rigidity of Classical Management Theory. These schools have emphasized the importance of managerial style, informal group activities, and questioning operational norms, but they have had notable failures to integrate the 1) psychological and emotional reactions and 2) individual and group interrelationships in a way that directly improves productivity or increases the value of hidden intellectual capital. This failure has been due in part the lack of an easy-to-use tool to recognize, characterize, and analyze the interdependent structural, psychological and relationship-based aspects of an organization""s hidden intellectual capital.
It is therefore desired to develop a novel solution to this problem by providing an analytic tool that allows the discovery of linkages between all different capital assets that comprise the overall market value of a company. Such a tool will help show the different forms of intellectual capital and how they can directly affect physical, financial, and structural capital of an organization. This tool will help in understanding and maximizing the interaction between different forms of capital in a way that enhances the overall market value of an enterprise.
In both the exemplary cases of biopsychosocial analysis and analysis of the capital of a business, the analysis is predicated on two or more related factors. In the case of biopsychosocial analysis, those factors are the social factors, biological or physical factors, and psychological factors. There is a relationship between the social and biological factors, between the psychological and biological factors, and between the social and psychological factors; for example, social factors may influence a person""s physical well being, as may psychological factors. In the exemplary case of total capital analysis, those factors are 1) relationships including those between employees, customers, and organizations 2) motivation and behavior including those of customers, suppliers, employees and the organization and 3) other forms of capital of the organizations involved. There are relationships between #1 and #2, #1 and #3, and #2 and #3.
Self-help materials and tools have gained great popularity over the last several decades. People often seek ways to be introspective to solve their problems or to better equip themselves to ask questions of their health care providers. It is advantageous, however, if the person and the health care provider use the same materials and/or tools. Thus, it is desired to provide an analysis tool which can be used by the individual and the health care provider, either alone or in combination.
The present invention comprises an apparatus and method for analysis of a plurality of factors, some of which may be related to each other. In one embodiment of the apparatus of the present invention, the analysis involves a first factor and a second factor, with the first and second factors related to each other as expressed by a first relationship. The apparatus comprises a base divided into first, second, and third sections representative of the first factor, first relationship, and second factor, respectively. Each of the sections are further subdivided into a first subsection and a second subsection. The first subsection is indicative of a symptom, event, experience, problem, or causal relation, and the second subsection is indicative of a solution, treatment, needed change, or adjustment. The method of the present invention comprises use of such an apparatus and engaging in a dialogue involving a plurality of questions related to both the first and second factors. The dialogue may involve only one person or more than one person, and the questions are directed toward identifying the answers to each of the subsections of the sections of the base. The user(s) may use markers to keep track of the user(s)""s responses. Those markers may have words, symbols, or colors thereon, and may be made to match the shape of the subsections of the base.
In another embodiment of the present invention, the apparatus is comprised of five sections corresponding to three factors with one of the factors related to each of the other two factors. Each of the factors of analysis in this embodiment is subdivided into four subsections indicative of a: (1) symptom, event, experience, or problem; (2) causal relation; (3) solution or treatment; and (4) needed change or adjustment, respectively. In this manner the event, cause, solution, and adjustments for all three factors and for the relationships between the factors may be explored by the user(s) of the apparatus.
In one application of this embodiment, the analysis performed using the device is biopsychosocial analysisxe2x80x94evaluating biological, psychological, and social/environmental factors, with a biosocial relationship between the biological and the social/environmental factors, a biopsychological relationship between the biological and psychological factors, and a psychosocial relationship between the psychological and social/environmental factors. In this application, the individual (or an individual with his/her health care professional) can explore the biological, psychological, and social/environmental factors that may impact the individual""s health.
In another application of this embodiment, the factors evaluated are relationships (those of employees, customers and the organizations), motivation and behavior (those of the employees and the organization), and other capital assets of an organization. The user of this application can evaluate the full range of the organization""s assets, including its intangible assets such as intellectual capital.
In yet another application, the analysis tool of the present invention is presented in electronic form. The apparatus includes a processor, display terminal, user input mechanism and software. The software may reside on a personal computer, for example, or be accessible over a network, such as a global computer network known as the Internet.